Provider Demographics
NPI:1457989535
Name:PERKINS, LAUREN (RBT, COTA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RBT, COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-2135
Mailing Address - Country:US
Mailing Address - Phone:812-265-8226
Mailing Address - Fax:
Practice Address - Street 1:1405 GILLOCK RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-9511
Practice Address - Country:US
Practice Address - Phone:877-498-0319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician